Study of autopsy diagnosis of early myocardial infarction (MI) by triphenyl tetrazolium chloride (TTC) and histopathology

Abstract

Introduction: Sudden death was defined as one which has taken place within 24 hours from the onset of symptoms & signs of disease. The diagnosis of sudden death due to acute Myocardial Infarction (MI) is difficult not only for forensic expert but for pathologist as on gross examination one may not find infarct area. To determine the usefulness, efficiency and reliability of new technique (TTC), this study has been undertaken and comparative analysis of are carried out to determine MI during the autopsy along with routine histological examination by H&E stain. Material and Methods: Total 107 hearts were divided into 2 groups - 1) Control group - known cases of MI and ischemic heart disease. 2) Negative control group - cases of sudden natural death, as phyxial deaths and accidental traumatic cases. The heart slices are incubated in 1 % soln. of TTC in phosphate buffer at pH 8.5 at approximately 37°c for 20-30min. Unstained slice is read as positive and bright pink stained is negative Results: It is observed that in Group-1 out of 15 cases TTC staining technique was positive in 80% cases while H&E method was positive in 33.33% cases. Similarly in Group-2, out of 92 cases, TTC staining technique which is positive in 43.47% cases suggesting that the technique is more superior and sensitive technique to determine the cause of death as MI over H&E method which is positive in 22.82% cases. Conclusion: TTC staining technique is more sensitive & efficient method than the H&E stain. Keywords: Heart slice, H&E-staining, MI, Sudden death, TTC